NURS 623 gastrointestinal discussion board.
Discussion 10.1: Critical Thinking Question
A lot of gastrointestinal problems can be fixed with diet modification. Research has
shown that up to 25% of patients with irritable bowel syndrome have sensitivity to
certain foods (Ismail et al., 2018). The elimination of these foods, often referred to as
an elimination diet, decrease or eliminate their symptoms. Many patients may be
misdiagnosed with irritable bowel syndrome when in fact they have a food
sensitivity.
During my clinical time I have seen a lot of patients that benefit from food sensitivity
testing. The test that we use here in this clinical setting tests for more than just the 6
common food allergens: beef, shrimp, egg white, milk, peanut, and soybean. It also
tests for food sensitivity. The patient if given an easy-to-read list of foods that they
can have (marked in green), foods that they should avoid due to sensitivity (marked
in yellow) and foods that they should avoid completely (marked in red). The one
major issue with this test is that it is not covered by health insurance, so patients
have to pay out of pocket. The good thing is that I’ve seen great results once the
patient adjusts their diet to fit the lab results. They say the cost is worth the benefit of
not having IBS or abdominal pain symptoms.
For my treatment plan, I would provide a list of the food sensitivities to the patient to
avoid. After 4 weeks, I would follow-up with them on their compliance and
symptoms. The patients need to be educated that if they ingest the food they are
sensitive to, they could have a relapse of symptoms. One of the great things about
living in Colorado is that it is easy to create a diet to fit your needs, as there are
many (vegan, keto, gluten-free, etc )options in the grocery stores.
References
Ismail, F. W., Abid, S., Awan, S., & Lubna, F. (2018). Frequency of food
hypersensitivity in patients with Functional Gastrointestinal Disorders. Acta Gastro-
Enterologica Belgica, 81(2), 253–256. Retrieved from https://search-ebscohost-
com.proxy.library.maryville.edu/login.aspx?
direct=true&db=mdc&AN=30024695&site=eds-live&scope=site
Great discussion. I find this topic so interesting, especially how food can impact our
bodies, diseases, and quality of life. I feel we all know this innately, but our human
nature tends to ignore it for instant gratification instead. I am interested to know what
the test is called that you run and what modality/body fluid/skin does it test?
I was working with an internal medicine doctor who is starting to practice functional
medicine and she has helped so many people by helping them adjust their lifestyle
including diet, sleep, exercise, and social support. I saw so many patients benefit by
,NURS 623 gastrointestinal discussion board.
changing their diet, the reduction in disease burden of inflammatory diseases is
incredible when gut health is improved. She will frequently use the Elimination Diet
or Low FODMAP diet to control inflammation. The Elimination Diet is recommended
by the Institute for Functional Medicine as the gold standard for identifying food
allergies (2019). The Elimination Diet is a three week elimination of numerous foods
including soy, mixed nuts, peanuts, dairy, beef, canned meats, eggs, pork, shellfish,
butter, corn oil, margarine, mayonnaise, shortening, corn, potatoes, barley, rye,
wheat, and potentially citrus fruits (IFM, 2019). At the end of three weeks they
reintroduce foods one at a time over 48-72 hours, paying close attention to any
symptoms that develop (IFM, 2019). It has a similar layout as the one you suggest
where they get a list of foods in each category (vegetables, fruits, meats, dairy,
legumes, fats, etc) that they can eat, and then a list below to avoid. These diet
approaches are quite intense but can be extremely beneficial.
Thank you for your post,
Amber
References
The Institute for Functional Medicine. (IFM). (2019). Heal the gut with IFM
elimination diet. Retrieved from https://www.ifm.org/news-insights/toolkit-heal-
microbiome-ifm-elimination-diet/
Thank you for sharing your post about food sensitivities and irritable bowel
syndrome (IBS). Gastrointestinal problems can be difficult to diagnose and manage,
but the nurse practitioner should be comfortable with them because they are
extremely common. I agree with you that food sensitivities are the cause of several
stomach issues. It surprises me that up to 25% of patients with IBS have food
sensitivities (Ismail et al., 2018). This means that these individuals are going to
continue to have problems unless the trigger foods are identified. I have not had
clinicals is a setting that performs food sensitivity testing, but this testing seems very
useful and helpful. It is unfortunate that insurance does not cover this test, for it
sounds very beneficial and easy to understand. Your treatment plan for them to
avoid food irritants sounds like a good idea, and I also agree with your follow-up
schedule of 1 month to reevaluate their symptoms and compliance. That is very
convenient that your state of Colorado has so many special diet accommodations at
grocery store and restaurants. Thank you again for sharing!
Beth
References
Ismail, F. W., Abid, S., Awan, S., & Lubna, F. (2018). Frequency of food
hypersensitivity in patients with Functional Gastrointestinal Disorders. Acta Gastro-
Enterologica Belgica, 81(2), 253–256. Retrieved from https://search-ebscohost-
com.proxy.library.maryville.edu/login.aspx?
direct=true&db=mdc&AN=30024695&site=eds-live&scope=site (Links to an external
site.)
,NURS 623 gastrointestinal discussion board.
I really enjoyed reading your post on the effectiveness of the elimination diet and
food sensitivity testing. It is amazing the things that can be genetically tested
nowadays. Unfortunately, the insurance companies are obviously not on the same
side when it comes to food sensitivity testing, or they would help with the cost of the
test. Irritable bowel syndrome (IBS) is the most common functional gastrointestinal
(GI) disorder with a worldwide prevalence of about 10–15% (About IBS, 2019).
Women are affected more so than men and a significant portion (40-75%) of the
women that have symptoms of irritable bowel syndrome have had abdominal
surgeries (About IBS, 2019).
Luckily, I have never experienced any symptoms of IBS, but I can honestly say that I
understand why so many patients present to the clinic with complaints of abdominal
pain, cramping, and bloating that is typically relieved or partially relieved by passing
a bowel movement (Mayo Clinic, 2019). Other symptoms that patients with IBS may
experience include excess gas, diarrhea or constipation, and mucus in the stool
(Mayo Clinic, 2019).
I agree with your treatment plan for patients such as this. A basic list of foods to
avoid is a great starting position. Hopefully, with the necessary dietary changes and
learning to avoid other triggers such as excess stress, these patients can live a life
with much less abdominal pain.
Thank you for sharing
References:
About IBS. (2019). Statistics. Retrieved from https://www.aboutibs.org/facts-about-
ibs/statistics.html (Links to an external site.)
Mayo Clinic. (2019). Irritable bowel syndrome. Retrieved from
https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-
causes/syc-20360016
That was interesting to learn that 20% of IBS was related to food allergies. I knew
that IBS was often associated with other conditions including fibromyalgia, chronic
fatigue syndrome, gastroesophageal reflux disease, and dyspepsia (IBS, 2018).
The signs and symptoms of IBS are similar to what we would expect in a patient who
was having a food allergy. Pain, cramping, bloating, and at times diarrhea.
Reports indicate that 40% of Americans meet criteria for IBS, but are misdiagnosed.
Symptoms of IBS are one of the leading causes of referrals to Gastroenterologists
(IBS, 2018). Having the ability to test for allergies in the office for the most common
food allergens will lead to less referrals and not waste resources while increasing
patient satisfaction.
Reference:
Wald, A. (2018). Clinical manifestations and diagnosis of irritable bowel syndrome in
adults. Uptodate. Retrieved from https://www.uptodate.com/contents/clinical-
manifestations-and-diagnosis-of-irritable-bowel-syndrome-in-adults?search=irritable
, NURS 623 gastrointestinal discussion board.
%20bowel%20syndrome%20patient
%20info&source=search_result&selectedTitle=4~150&usage_type=default&display_
rank=4 (Links to an external site.)
Wonderful post regarding the treatment of IBS with a low FODMAP diet. This
option as a treatment of IBS has proven to be effective in the elimination and
reduction of symptoms. However, there are other options that are available and
should be considered as alternative treatment.
Physical activity should be advised in patients with IBS given a potential benefit with
regard to IBS symptoms and the general health benefits of exercise (Wald, 2019).
Stress is a well-known trigger for IBS symptoms. Nerves in the colon control
contractions of colon muscles to keep things moving (Wald, 2019). However, in
times of stress, these nerves can cause abdominal pain. People with IBS are more
sensitive to stress-induced abdominal symptoms, so it makes sense for stress
reduction to be an important part of managing your IBS symptoms (Wald, 2019). For
IBS patients who experience frequent constipation, exercise offers an added benefit.
In addition to improving your overall fitness level and reducing the stress in your life,
exercise has been shown to help keep your digestive system working properly and
may even decrease the occurrence of constipation (Wald, 2019).
Wald, R. (2019). Treatment of irritable bowel syndrome in adults. Grover, S. (Ed.)
Retrieved from https://www-uptodate-com.proxy.library.maryville.edu/contents/
treatment-of-irritable-bowel-syndrome-in-adults?
search=IBS&source=search_result&selectedTitle=1~150&usage_type=default&displ
ay_rank=1#H86846755 (Links to an external site.)
I agree from personal experience that a lot of GI issues can be improved, and in
some cases eliminated with food sensitivity testing and/or elimination diets. My
husband was experiencing horrible gastric upset. Symptoms included excessive
burping, stomach upset, distention, gas and towards the end; difficulty swallowing.
We were seen by GI and after acquiring a thorough history, he received a EGD w/
biopsy.
He was diagnosed with Eosinophillic Esophagitis. While there are a list of common
foods that increase symptoms; there are no definitive triggers. Based off his prior
history; we opted to try an elimination diet. However, food sensitivity testing is a
wonderful alternative. It is amazing how our bodies develop sensitivities as we age;
especially when you have eaten them previously. What's even more amazing is to
see how this sensitivities manifest themselves in our GI tract.
Manage Discussion Entry
This week's topic is a favorite of mine. For my specialty hours, I was able to do 60
hours in a GI clinic where we only saw about 12 patients a day, but the
appointments were a good 45 minute windows. The nurse practitioner I followed was
phenomenal and was so good at collecting a thorough history. I have to admit it did
Discussion 10.1: Critical Thinking Question
A lot of gastrointestinal problems can be fixed with diet modification. Research has
shown that up to 25% of patients with irritable bowel syndrome have sensitivity to
certain foods (Ismail et al., 2018). The elimination of these foods, often referred to as
an elimination diet, decrease or eliminate their symptoms. Many patients may be
misdiagnosed with irritable bowel syndrome when in fact they have a food
sensitivity.
During my clinical time I have seen a lot of patients that benefit from food sensitivity
testing. The test that we use here in this clinical setting tests for more than just the 6
common food allergens: beef, shrimp, egg white, milk, peanut, and soybean. It also
tests for food sensitivity. The patient if given an easy-to-read list of foods that they
can have (marked in green), foods that they should avoid due to sensitivity (marked
in yellow) and foods that they should avoid completely (marked in red). The one
major issue with this test is that it is not covered by health insurance, so patients
have to pay out of pocket. The good thing is that I’ve seen great results once the
patient adjusts their diet to fit the lab results. They say the cost is worth the benefit of
not having IBS or abdominal pain symptoms.
For my treatment plan, I would provide a list of the food sensitivities to the patient to
avoid. After 4 weeks, I would follow-up with them on their compliance and
symptoms. The patients need to be educated that if they ingest the food they are
sensitive to, they could have a relapse of symptoms. One of the great things about
living in Colorado is that it is easy to create a diet to fit your needs, as there are
many (vegan, keto, gluten-free, etc )options in the grocery stores.
References
Ismail, F. W., Abid, S., Awan, S., & Lubna, F. (2018). Frequency of food
hypersensitivity in patients with Functional Gastrointestinal Disorders. Acta Gastro-
Enterologica Belgica, 81(2), 253–256. Retrieved from https://search-ebscohost-
com.proxy.library.maryville.edu/login.aspx?
direct=true&db=mdc&AN=30024695&site=eds-live&scope=site
Great discussion. I find this topic so interesting, especially how food can impact our
bodies, diseases, and quality of life. I feel we all know this innately, but our human
nature tends to ignore it for instant gratification instead. I am interested to know what
the test is called that you run and what modality/body fluid/skin does it test?
I was working with an internal medicine doctor who is starting to practice functional
medicine and she has helped so many people by helping them adjust their lifestyle
including diet, sleep, exercise, and social support. I saw so many patients benefit by
,NURS 623 gastrointestinal discussion board.
changing their diet, the reduction in disease burden of inflammatory diseases is
incredible when gut health is improved. She will frequently use the Elimination Diet
or Low FODMAP diet to control inflammation. The Elimination Diet is recommended
by the Institute for Functional Medicine as the gold standard for identifying food
allergies (2019). The Elimination Diet is a three week elimination of numerous foods
including soy, mixed nuts, peanuts, dairy, beef, canned meats, eggs, pork, shellfish,
butter, corn oil, margarine, mayonnaise, shortening, corn, potatoes, barley, rye,
wheat, and potentially citrus fruits (IFM, 2019). At the end of three weeks they
reintroduce foods one at a time over 48-72 hours, paying close attention to any
symptoms that develop (IFM, 2019). It has a similar layout as the one you suggest
where they get a list of foods in each category (vegetables, fruits, meats, dairy,
legumes, fats, etc) that they can eat, and then a list below to avoid. These diet
approaches are quite intense but can be extremely beneficial.
Thank you for your post,
Amber
References
The Institute for Functional Medicine. (IFM). (2019). Heal the gut with IFM
elimination diet. Retrieved from https://www.ifm.org/news-insights/toolkit-heal-
microbiome-ifm-elimination-diet/
Thank you for sharing your post about food sensitivities and irritable bowel
syndrome (IBS). Gastrointestinal problems can be difficult to diagnose and manage,
but the nurse practitioner should be comfortable with them because they are
extremely common. I agree with you that food sensitivities are the cause of several
stomach issues. It surprises me that up to 25% of patients with IBS have food
sensitivities (Ismail et al., 2018). This means that these individuals are going to
continue to have problems unless the trigger foods are identified. I have not had
clinicals is a setting that performs food sensitivity testing, but this testing seems very
useful and helpful. It is unfortunate that insurance does not cover this test, for it
sounds very beneficial and easy to understand. Your treatment plan for them to
avoid food irritants sounds like a good idea, and I also agree with your follow-up
schedule of 1 month to reevaluate their symptoms and compliance. That is very
convenient that your state of Colorado has so many special diet accommodations at
grocery store and restaurants. Thank you again for sharing!
Beth
References
Ismail, F. W., Abid, S., Awan, S., & Lubna, F. (2018). Frequency of food
hypersensitivity in patients with Functional Gastrointestinal Disorders. Acta Gastro-
Enterologica Belgica, 81(2), 253–256. Retrieved from https://search-ebscohost-
com.proxy.library.maryville.edu/login.aspx?
direct=true&db=mdc&AN=30024695&site=eds-live&scope=site (Links to an external
site.)
,NURS 623 gastrointestinal discussion board.
I really enjoyed reading your post on the effectiveness of the elimination diet and
food sensitivity testing. It is amazing the things that can be genetically tested
nowadays. Unfortunately, the insurance companies are obviously not on the same
side when it comes to food sensitivity testing, or they would help with the cost of the
test. Irritable bowel syndrome (IBS) is the most common functional gastrointestinal
(GI) disorder with a worldwide prevalence of about 10–15% (About IBS, 2019).
Women are affected more so than men and a significant portion (40-75%) of the
women that have symptoms of irritable bowel syndrome have had abdominal
surgeries (About IBS, 2019).
Luckily, I have never experienced any symptoms of IBS, but I can honestly say that I
understand why so many patients present to the clinic with complaints of abdominal
pain, cramping, and bloating that is typically relieved or partially relieved by passing
a bowel movement (Mayo Clinic, 2019). Other symptoms that patients with IBS may
experience include excess gas, diarrhea or constipation, and mucus in the stool
(Mayo Clinic, 2019).
I agree with your treatment plan for patients such as this. A basic list of foods to
avoid is a great starting position. Hopefully, with the necessary dietary changes and
learning to avoid other triggers such as excess stress, these patients can live a life
with much less abdominal pain.
Thank you for sharing
References:
About IBS. (2019). Statistics. Retrieved from https://www.aboutibs.org/facts-about-
ibs/statistics.html (Links to an external site.)
Mayo Clinic. (2019). Irritable bowel syndrome. Retrieved from
https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-
causes/syc-20360016
That was interesting to learn that 20% of IBS was related to food allergies. I knew
that IBS was often associated with other conditions including fibromyalgia, chronic
fatigue syndrome, gastroesophageal reflux disease, and dyspepsia (IBS, 2018).
The signs and symptoms of IBS are similar to what we would expect in a patient who
was having a food allergy. Pain, cramping, bloating, and at times diarrhea.
Reports indicate that 40% of Americans meet criteria for IBS, but are misdiagnosed.
Symptoms of IBS are one of the leading causes of referrals to Gastroenterologists
(IBS, 2018). Having the ability to test for allergies in the office for the most common
food allergens will lead to less referrals and not waste resources while increasing
patient satisfaction.
Reference:
Wald, A. (2018). Clinical manifestations and diagnosis of irritable bowel syndrome in
adults. Uptodate. Retrieved from https://www.uptodate.com/contents/clinical-
manifestations-and-diagnosis-of-irritable-bowel-syndrome-in-adults?search=irritable
, NURS 623 gastrointestinal discussion board.
%20bowel%20syndrome%20patient
%20info&source=search_result&selectedTitle=4~150&usage_type=default&display_
rank=4 (Links to an external site.)
Wonderful post regarding the treatment of IBS with a low FODMAP diet. This
option as a treatment of IBS has proven to be effective in the elimination and
reduction of symptoms. However, there are other options that are available and
should be considered as alternative treatment.
Physical activity should be advised in patients with IBS given a potential benefit with
regard to IBS symptoms and the general health benefits of exercise (Wald, 2019).
Stress is a well-known trigger for IBS symptoms. Nerves in the colon control
contractions of colon muscles to keep things moving (Wald, 2019). However, in
times of stress, these nerves can cause abdominal pain. People with IBS are more
sensitive to stress-induced abdominal symptoms, so it makes sense for stress
reduction to be an important part of managing your IBS symptoms (Wald, 2019). For
IBS patients who experience frequent constipation, exercise offers an added benefit.
In addition to improving your overall fitness level and reducing the stress in your life,
exercise has been shown to help keep your digestive system working properly and
may even decrease the occurrence of constipation (Wald, 2019).
Wald, R. (2019). Treatment of irritable bowel syndrome in adults. Grover, S. (Ed.)
Retrieved from https://www-uptodate-com.proxy.library.maryville.edu/contents/
treatment-of-irritable-bowel-syndrome-in-adults?
search=IBS&source=search_result&selectedTitle=1~150&usage_type=default&displ
ay_rank=1#H86846755 (Links to an external site.)
I agree from personal experience that a lot of GI issues can be improved, and in
some cases eliminated with food sensitivity testing and/or elimination diets. My
husband was experiencing horrible gastric upset. Symptoms included excessive
burping, stomach upset, distention, gas and towards the end; difficulty swallowing.
We were seen by GI and after acquiring a thorough history, he received a EGD w/
biopsy.
He was diagnosed with Eosinophillic Esophagitis. While there are a list of common
foods that increase symptoms; there are no definitive triggers. Based off his prior
history; we opted to try an elimination diet. However, food sensitivity testing is a
wonderful alternative. It is amazing how our bodies develop sensitivities as we age;
especially when you have eaten them previously. What's even more amazing is to
see how this sensitivities manifest themselves in our GI tract.
Manage Discussion Entry
This week's topic is a favorite of mine. For my specialty hours, I was able to do 60
hours in a GI clinic where we only saw about 12 patients a day, but the
appointments were a good 45 minute windows. The nurse practitioner I followed was
phenomenal and was so good at collecting a thorough history. I have to admit it did
